Whether you are a patient or visitor at Sunrise Hospital, we want your experience with us to be as pleasant as possible. We have provided helpful information to help you during your stay or while visiting a patient in the hospital.

Failure-to-Thrive

Definition

Failure-to-thrive is when a child is not growing as expected. It does not include children who are small for their age. Definitions of failure-to-thrive may vary.

Children
grow quickly in the first few years of life. A child with failure-to-thrive will usually have a height and weight that is well below other children of their age. Your child may have also had a normal growth pattern that began to slow down. Initially the child has similar height and weight than their peers but at follow-up appointments the child's height and weight does not keep up with their peers.

Growth is assessed at health visits by measuring height, weight, and head circumference. This information is entered into a growth chart, which makes a line or curve that follows how your child grows. Standard curve lines on the chart called percentiles show where babies fall in terms of normal growth compared to other babies at specific ages. Failure-to-thrive can occur when a child:

Is at or below the third to fifth percentile for height and weight.

Has failed to grow as expected. This is shown by crossing two percentile lines on the growth chart.

Failure-to-thrive is split into three different types.
These types include:

Organic—caused by some medical condition

Nonorganic—occurs in children with no known medical condition

Mixed—occurs when the child has features of both

Causes

Failure-to-thrive is caused by a lack of nutrition. The most common causes of lack of nutrition include:

Inadequate food intake

Malabsorption—inability of the intestines to properly absorb nutrients from food

Loss of nutrients, which may occur from excessive vomiting or diarrhea

Inability to process nutrients correctly

Increased energy expenditure

Risk Factors

Failure-to-thrive is more common in boys. Many factors may contribute to an increased chance of developing failure-to-thrive in children, including:

Medical conditions:

Genetic disorders, such as
cystic fibrosis, Down Syndrome, or Turner syndrome

Diagnosis

Failure-to-thrive is diagnosed based on following a child's growth. Your child's weight, height, and head circumference will be potted on standard growth charts. If the child falls below a certain weight range or crosses two lines on the growth chart, the doctor will evaluate the child further.

Based on your child's symptoms, additional tests may be ordered.

Rarely, a child must be hospitalized for a period of time to find the cause of failure-to-thrive. During this time, the doctor will:

Monitor the relationship between parent and child, paying particular attention to their behavior around feeding

Set up a feeding schedule with an adequate amount of calories

Make sure that an appropriate feeding technique is used

This will also be done in an outpatient setting and often require referrals to feeding specialists.

If your child can gain weight under these circumstances and no underlying disease is found, this supports the diagnosis of nonorganic failure-to-thrive.

Treatment

Talk with your child's doctor about the best treatment plan. Treatment will depend on what is causing your child's failure-to-thrive. Options may include:

Treating a Medical Condition

Providing Extra Calories

Children who are malnourished may need a dietary supplement. These may include Ensure/PediaSure, milk fortifiers, and other ways to add calories to food. They help improve nutrition and boost growth.

Parent Training

When a child is hospitalized for diagnosis, the hospital staff can also provide treatment. Nurses can teach parents appropriate feeding techniques. They may also show how to best interact with their child. If the child isn't hospitalized, parents can still have training sessions with a nutritionist or a nurse.

Counseling

Parents and children who are having difficulty with their relationship may benefit from counseling.

Prevention

To help reduce your child's chance of developing failure-to-thrive:

Take your children to the doctor regularly to have their growth checked. This helps detect and treat failure-to-thrive before it becomes severe.

Develop a good relationship with your child's doctor.

Ask the doctor about proper parenting and nutrition for early in a baby's life.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.